Healthcare Provider Details
I. General information
NPI: 1669408332
Provider Name (Legal Business Name): ALBANY MEDICAL CENTER SOUTH CLINICAL CAMPUS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/24/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
25 HACKETT BLVD MAIL CODE 113
ALBANY NY
12208-3420
US
IV. Provider business mailing address
618 CENTRAL AVE MAIL CODE 106
ALBANY NY
12206-1916
US
V. Phone/Fax
- Phone: 518-262-8481
- Fax: 518-262-8146
- Phone: 518-262-9702
- Fax: 518-262-9707
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085B0100X |
| Taxonomy | Body Imaging Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085N0700X |
| Taxonomy | Neuroradiology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085N0904X |
| Taxonomy | Nuclear Radiology Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085P0229X |
| Taxonomy | Pediatric Radiology Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0203X |
| Taxonomy | Therapeutic Radiology Physician |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0205X |
| Taxonomy | Radiological Physics Physician |
| License Number | |
| License Number State | |
| # 9 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085U0001X |
| Taxonomy | Diagnostic Ultrasound Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
STEVEN
M
FRISCH
Title or Position: DIRECTOR OF HOSPITAL OPERATIONS
Credential: M.D.
Phone: 518-262-3028